Objective
Intracranial metastases from primary laryngeal carcinoma are extremely rare and to present as diminution of vision has not been reported in published English literature. We present a case of advanced laryngeal carcinoma, who after treatment with surgery and chemo radiation, presented with decreased vision and weakness of lower limbs secondary to brain metastases.
Case report
A 35-year-old male presented with dysphonia and L upper neck swelling. Endoscopy revealed a left supraglottic mass with fixed vocal cord and pathology of primary site and neck swelling reported it as moderately differentiated squamous cell carcinoma. Clinical and radiological assessment staged the tumor as T3N2bM0. Patient underwent combined standard surgical and medical treatment. Eight months after completion of treatment patient presented as decreased visual acuity (R > L) and gradually progressing weakness of lower limbs. Evidence of papilloedema on fundus exam prompted an urgent CT brain which showed multiple metastatic deposits in brain. There was no evidence of metastases in lungs, bones or liver.
Conclusion
Brain metastases are a known entity in Head and Neck cancer. Larynx as a primary site for the same should be kept in consideration with an atypical presentation as in present case.
Objective: Recurrence of a typical laryngeal carcinoid is extremely rare after surgery with tumor-free margins on histopathology. We present a rare case of typical laryngeal carcinoid that recurred after eight years and was managed by conservative surgery.
Methods:
Design: Case report
Setting: Tertiary Government Hospital
Patient: One
Results: A known case of typical laryngeal carcinoid treated eight years back reported again with the same symptoms he previously had. On evaluation local tumor recurrence was identified with a negative metastatic workup. The patient was subjected to microlaryngeal excision which was adequate histopathologically. He has had no evidence of disease on follow up of two years.
Conclusion: A typical laryngeal carcinoid tumor may present differently and recur locally but conservative surgery is still an option if local nodal and distant metastatic spread is ruled out.
Key words: neuroendocrine tumor,typical laryngeal carcinoid, microlaryngeal excision. hemoptysis
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